ABC | Volume 113, Nº4, October 2019

Original Article Abolhasani et al. Serum levels of markers in CAD prediction Arq Bras Cardiol. 2019; 113(4):667-674 Figure 2 – ROC curve of combined assay. VN: vitronectin; MDA: malondialdehyde; OX-LDL: oxidized low density lipoprotein; PAI-1: plasminogen activator inhibitor-1; hs‑CRP: high-sensitivity C‑reactive protein; SA: sialic acid. ROC Curve Sensitivity 1.0 0.8 0.6 0.4 0.2 0.0 1 – Specificity 0.0 0.2 0.4 0.6 0.8 1.0 Source of the Curve OX-LDL-MDA-PAI-1- hscrp-sialicacid OX-LDL-MDA-hscrp- sialicacid-VN OX-LDL-VN-PAI-1-hscrp- sialicacid VN-MDA-PAI-1-hscrp- sialicacid OX-LDL-MDA-PAI-1-VN- hscrp-sialicacid Reference Line One of limitations of this study is the probability of a non- representative sample, in an attempt to select a random sample, since the hospital is a referral hospital and the patients approached this hospital in special days, which may lead to selection bias. Also, this study is only cross-sectional, which might not show temporal relationships, and thus the observed associations may not necessarily be causal. Conclusions In the present study, high serum concentrations of SA (≥7/89 mg/dL), hs-CRP (≥3.4 mg/dL), PAI-1 (≥67 ng/mL) and increase in OX-LDL, MDA, and VN were found to be independent significant predictors of CAD in patients. In addition, the results suggested that using serum levels of hs‑CRP, SA, PAI-1, OX-LDL, MDA, and VN may be helpful in clinical monitoring. The combined assay of serum PAI‑1, OX‑LDL, MDA, and VN can improve the sensitivity and specificity for diagnosing CAD, and can be used for population screening and for monitoring patients with CAD. Therefore, while we suggest the use of these biomarkers as a diagnostic apparatus for CAD patients, they need to be further explored to confirm this suggestion. Author contributions Conception and design of the research and Obtaining financing: Abolhasani S; Acquisition of data: Mahmoodi N; Analysis and interpretation of the data: Shahbazloo SV; Statistical analysis: Saadati HM; Writing of the manuscript: Abolhasani S, Khanbabaei N; Critical revision of the manuscript for intellectual content: Khanbabaei N. Potential Conflict of Interest No potential conflict of interest relevant to this article was reported. Sources of Funding This study was funded Student Research Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Study Association This study is not associatedwith any thesis or dissertationwork. Ethics approval and consent to participate This study was approved by the Ethics Committee of the Medical Faculty of the Tabriz University of Medical Sciences under the protocol number 91/2-3/5. All the procedures in this study were in accordance with the 1975 Helsinki Declaration, updated in 2013. Informed consent was obtained from all participants included in the study. 672